UPI (Provider ID): 10089
Change Report (if Any):

Short Name: CROSSROADS-TRUM

Long Name 1: CROSSROADS
Long Name 2:

Address 1: 1269 YOUNGSTOWN ROAD SE
Address 2:

City: WARREN
Zip Code: 44484
County: TRUM

Contact: SUSAN MOCKER
Title: PRDIR
Phone: 3303698708
FAX: 3303698717

Vendor: 2891

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012